Blood pressure response to six-minute walk test in hypertensive subjects exposed to high altitude: Effects antihypertensive combination treatment

Morin Lang, Andrea Faini, Sergio Caravita, Grzegorz Bilo, Cecilia Anza-Ramìrez, Francisco C. Villafuerte, Jose Luis Macarlupu, Elisabetta Salvioni, Piergiuseppe Agostoni, Gianfranco Parati

Research output: Contribution to journalArticlepeer-review

Abstract

Background Limited evidence exists on blood pressure (BP) responses to exercise in hypertensive subjects exposed to high altitude, and on the effects of antihypertensive treatment in this setting. We aimed to asses BP response to submaximal exercise in hypertensive lowlanders acutely exposed to high altitude, and the effects of a calcium antagonist-angiotensin receptor blocker combination in this condition. Methods 89 mild-hypertensive participants in HIGHCARE-ANDES study performed a six-minute walk test in 3 conditions: at sea-level off-treatment; at sea-level after 6 weeks of double-blind treatment with telmisartan 80mg + slow release nifedipine 30 mg or with placebo; on the first full day of permanence at 3260 m altitude under randomized treatment. Results The distance walked in 6 min was reduced by about 10% at high altitude in both groups (p <0.001) without treatment-related differences. Systolic BP increased at altitude in both groups, remaining lower on telmisartan/nifedipine than on placebo both before and after exercise (p <0.001).The exercise-induced increase in systolic BP at altitude was blunted by active treatment as compared to placebo (+ 32.0 ± 19.8 vs + 41.9 ± 23.3 mm Hg, p <0.05). Diastolic BP was unchanged from sea-level to altitude in both groups, showing lower values on telmisartan/nifedipine than on placebo before and after exercise (p <0.01). Oxygen saturation was similarly reduced in both groups before exercise at altitude, but after exercise it was higher on telmisartan/nifedipine than on placebo. Conclusions In mild hypertensives, acute exposure to high altitude enhances the BP response to exercise. Such an enhanced response is effectively reduced by telmisartan/nifedipine combination therapy, without affecting exercise performance.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalInternational Journal of Cardiology
Volume219
DOIs
Publication statusPublished - Sep 15 2016

Keywords

  • Blood pressure
  • Exercise
  • High altitude hypoxia
  • Hypertension
  • Six-minute walk test

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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